Cardiac Catheterization

The thought of undergoing open-heart surgery can be frightening for some patients. The good news is that not all heart problems require this procedure. Qualified patients may benefit from cardiac catheterization, a minimally invasive technique for diagnosing or treating a range of heart problems.

What Is Cardiac Catheterization Done For?

A cardiac catheterization procedure is a way to examine how well your heart is functioning. It involves inserting a thin, flexible tube called a catheter from the arm or groin into the heart. A cardiac cath can measure blood pressure and oxygen levels in the pulmonary arteries and heart chambers to check your heart’s condition.

Heart doctors use cardiac catheterization to confirm results from cardiovascular tests such as echocardiography (ECG), cardiac magnetic resonance imaging (MRI) or computer tomography (CT) scan. It is a reliable way to diagnose:

  • Arrhythmia
  • Cardiomyopathy
  • Coronary heart disease
  • Heart attack
  • Heart valve diseases
  • Pulmonary hypertension

Specific procedures performed to treat or diagnose a heart condition during a heart catheterization procedure include:

  • Catheter ablation for arrhythmia treatment
  • Coronary angiography to inspect the heart or blood vessels by injecting dye through the catheter
  • Heart tissue biopsies to look for transplant rejection or check for myocarditis
  • Minor heart surgery to widen or replace cardiac valves and treat congenital heart defects
  • Percutaneous coronary intervention (PCI) to open blocked or narrowed coronary arteries
  • Valvuloplasty to widen a narrowed cardiac valve opening

Our Heart and Vascular Institute in West Palm Beach, FL houses a cardiac cath lab where we perform the following procedures:

  • Balloon angioplasty
  • Coronary and left ventricular digital angiography
  • Coronary intravascular ultrasound
  • Right and left heart catheterization
  • Rotational atherectomy
  • Stent implantation
  • Thrombectomy

Who Are the Candidates for Cardiac Catheterization?

Cardiac catheterizations can provide more information about how well your heart works, identify problems, and allow procedures to open blocked arteries. Only your cardiologist and primary care physician can determine if you need heart catheterization. This procedure may be recommended if you experience the following heart attack symptoms:

  • Chest pain
  • Dizziness
  • Fatigue
  • Shortness of breath

If you have any of these conditions, your doctor may wait or not recommend a cardiac cath for you:

  • Abnormal electrolyte levels in the blood
  • Acute gastrointestinal bleeding
  • Acute kidney failure
  • Acute stroke
  • High levels of digoxin in blood, a medicine to treat heart failure or arrhythmia
  • Previous serious allergic reaction to the cardiac cath dye
  • Severe anemia
  • Severe kidney disease
  • Thin blood
  • Unexplained fever
  • Untreated infection

Before you qualify for cardiac catheterization, your doctor will thoroughly review your health history and medical test results. Your intensive diagnostic study will include a basic metabolic panel (BMP), prothrombin time, chest X-ray, electrocardiogram and complete blood count (CBC).

If you are allergic to radio-iodinated contrast material, your doctor may ask you to take antihistamines and corticosteroids. Patients with chronic kidney disease need adequate pre-hydration and planning to reduce the risk of worsening kidney function.

How Serious Is Heart Catheterization?

Cardiac catheterization is generally a safe procedure with very minimal risks. It is natural to feel discomfort or develop bruises in the catheter’s puncture site. Some people may develop allergic reactions from the contrast dye used in heart catheterization diagnosis.

How Do I Prepare for a Visit to the Cath Lab?

Cardiac catheterization is not a major surgery but can be used to evaluate a patient for possible heart surgery and diagnose and treat various heart conditions. If your doctor and cardiologist recommend you undergo cardiac lab, you will receive more detailed instructions on preparing for your cardiac catheterization laboratory visit.

Usually, your doctor will instruct you not to drink or eat for up to eight hours before your procedure. Tell your doctor about any medicines you take, as they may ask you not to take them before your cath procedure. Disclose if you are allergic to shellfish, iodine, rubber or latex products, penicillin, X-ray dye and more. You can bring your hearing aid or eyeglasses during your appointment. Make sure you have someone to drive you home after your procedure.

How Is the Procedure Performed?

A cardiac cath procedure is usually done in a cardiac catheterization lab. A doctor with special training works with the support of radiologic technologists and registered nurses to perform the procedure safely. Various tools may be placed at the catheter’s tip, such as those used for:

  • Measuring blood pressure in heart chambers
  • Removing a tissue sample from the heart
  • Taking blood samples from different parts of the heart
  • Viewing the blood vessel interior

Most cardiac cath procedures can be performed with moderate or minimal local anesthetic sedation. It can last for about an hour. Local anesthesia means a small area of the body is numbed, and the patient remains conscious. On the other hand, other heart catheterization procedures require patients to undergo general anesthesia, so they remain unconscious.

Before the catheterization procedure, a nurse will put an intravenous line into your arm’s vein where a sedative will pass through, helping you relax. A lower sedative dosage will keep you awake and able to follow instructions during the procedure. The nurse will shave and clean the area the doctor will work on. A local anesthetic may be used to numb the puncture site.

The doctor will prick through your skin and into a large blood vessel where a straw-sized tube called a sheath will be inserted. Then the doctor will insert a catheter through the sheath and into your vessel. A video monitor will show the location of the catheter as the doctor guides it through your major blood vessels and to the heart. You may feel some pressure in the puncture site, but there would not be pain.

After the doctor removes the sheath and catheter, the nurse will put pressure on the puncture site to prevent bleeding. A special closure device will be used if needed.

What Happens After Cardiac Catheterization?

You will be transferred to a recovery room where you will have to lie flat on a bed. You will be instructed to keep your legs straight. Your vital signs will be checked. Report immediately if you experience chest pain, bleeding or swelling at the puncture site. You will receive written instructions before you leave the hospital.

Most cardiac cath patients can return to their routines the day after their procedure, depending on whether additional interventions were performed during their appointment. Ensure you follow all instructions and take your medications as prescribed. Make follow-up appointments. A bruised puncture site is normal. If it bleeds, lie flat and press it firmly for a few minutes, then check if the bleeding has stopped.

Call your doctor if:

  • The puncture site’s bruising worsens, or the bleeding does not stop even after pressing on it
  • There is swelling or fluid draining from the puncture site
  • Your leg with the puncture site tingles or becomes numb, or your foot turns blue or feels cold

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